Commentary |

Proposal for a Revised 2-Step Algorithm for the Classification of Lesions of the Skin Using Dermoscopy

Ashfaq A. Marghoob, MD; Ralph Braun, MD
Arch Dermatol. 2010;146(4):426-428. doi:10.1001/archdermatol.2010.41.
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In 2001, the Board of the Consensus Net Meeting agreed on a 2-step algorithm for the classification of pigmented lesions of the skin.1 However, over the past few years, studies have documented the utility of dermoscopy in the evaluation of amelanotic and hypomelanotic neoplasms.2,3 In addition, some exceptions to the 2-step algorithm have also become evident.4,5 Furthermore, differences between polarized dermoscopy and nonpolarized dermoscopy have revealed important differences that need to be taken into account.68 Thus, an effort to make the 2-step algorithm as accurate and all encompassing as possible requires that some modifications be incorporated into it. For this reason, we would like to propose the algorithm as found in the Figure. This proposal is based on our personal clinical and teaching experience.

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The modified dermoscopy 2-step algorithm. SCC indicates squamous cell carcinoma. The schematic drawings are used with permission from the Handbook of Dermoscopy (Informa Healthcare).9

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